Contraceptive Provision to Women With Intellectual and Developmental Disabilities Enrolled in Medicaid

Area of Science:

• Public Health
• Reproductive Health
• Health Disparities

Background:

• Access to effective contraception is crucial for reproductive autonomy and health.
• Women with intellectual and developmental disabilities (IDD) may face unique barriers to healthcare, including contraceptive services.
• North Carolina Medicaid data provides a valuable resource for examining healthcare utilization patterns.

Purpose of the Study:

• To compare the provision of contraceptive methods to women with and without intellectual and developmental disabilities (IDD) enrolled in North Carolina Medicaid.
• To identify potential disparities in contraceptive access based on IDD status.

Main Methods:

• Retrospective cohort study using 2019 North Carolina Medicaid claims data.
• Inclusion of women aged 15-44 years at risk for pregnancy, with continuous enrollment or Family Planning Medicaid.
• Calculation of contraceptive receipt proportions (most/moderately effective, LARC, short-acting) and logistic regression analysis adjusting for covariates.

Main Results:

• A significantly smaller proportion of women with IDD received most or moderately effective contraception (30.1% vs. 36.3%).
• This disparity persisted across most contraceptive measures after adjusting for sociodemographic factors (aOR 0.75).
• Women with IDD receiving effective contraception had a higher prevalence of co-occurring menstrual disorders (31.3% vs. 24.3%).

Conclusions:

• Findings indicate significant disparities in contraceptive provision for women with IDD.
• Potential differences in clinical indications for contraception, such as menstrual disorders, warrant further investigation.
• Future research should explore barriers to contraceptive use and access for women with IDD.